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Operative Dentistry, 2013, 38-2, 186-196

In Vitro Shear Bond

Strength of Three Self-
adhesive Resin Cements
and a Resin-Modified Glass
Ionomer Cement to Various
Prosthodontic Substrates
Camila Sabatini  Manthan Patel  Eric D’Silva

Clinical Relevance
Self-adhesive resin cements demonstrated superior bond strength to a variety of
prosthodontic substrates relative to resin-modified glass ionomer cement, indicating that
they are able to provide a wider array of clinical applications. However, selection of the
cement should be determined largely by the type of substrate and setting reaction.

SUMMARY resin composite were used for bonding with

Objective: To evaluate the shear bond
strength (SBS) of three self-adhesive resin
cements and a resin-modified glass ionomer
cement (RMGIC) to different prosthodontic
substrates.
Materials and Methods: The substrates base
metal, noble metal, zirconia, ceramic, and
*Camila Sabatini, University at Buffalo, Restorative Dentist-
ry, Buffalo, NY, USA
Manthan Patel, University at Buffalo, Buffalo, NY, USA
Eric D’Silva, University at Buffalo, Buffalo, NY, USA
*Corresponding author: 3435 Main Street, 215 Squire Hall,
215 Squire Hall, Buffalo, NY 14214; e-mail: cs252@buffalo.
edu
DOI: 10.2341/11-317-L
different cements (n=12). Specimens were
placed in a bonding jig, which was filled with
one of four cements (RelyX Unicem, Multilink
Automix, Maxcem Elite, and FujiCEM Auto-
mix). Both light-polymerizing (LP) and self-
polymerizing (SP) setting reactions were test-
ed. Shear bond strength was measured at 15
minutes and 24 hours in a testing device at a
test speed of 1 mm/min and expressed in MPa.
A Student t-test and a one-way analysis of
variance (ANOVA) were used to evaluate dif-
ferences between setting reactions, between
testing times, and among cements irrespective
of other factors. Generalized linear regression
model and Tukey tests were used for multifac-
torial analysis.
Sabatini & Others: Shear Bond Strength of Self-Adhesive Cements to Various Prosthodontic Substrates 187
Results: Significantly higher mean SBS were
demonstrated for LP mode relative to SP mode
(p,0.001) and for 24 hours relative to 15
minutes (p,0.001). Multifactorial analysis re-
vealed that all factors (cement, substrate, and
setting reaction) and all their interactions had
a significant effect on the bond strength
(p,0.001). Resin showed significantly higher
SBS than other substrates when bonded to
RelyX Unicem and Multilink Automix in LP
mode (p,0.05). Overall, FujiCEM demonstrat-
ed significantly lower SBS than the three self-
adhesive resin cements (p,0.05).
Conclusions: Overall, higher bond strengths
were demonstrated for LP relative to SP mode,
24 hours relative to 15 minutes and self-adhe-
sive resin cements compared to the RMGICs.
Bond strengths also varied depending on the
substrate, indicating that selection of luting
cement should be partially dictated by the
substrate and the setting reaction.
INTRODUCTION
The long-term success of indirect restorations de-
pends on several factors, including an adequate
design, preparation, and selection of the restorative
material. An aspect equally important to the longev-
ity of indirect restorations is the integrity of the
bonded interface between the tooth and the restora-
tion. Currently, most resin cements use an etch-and-
rinse or a self-etch adhesive in combination with a
low-viscosity dual polymerizing resin cement.1 How-
ever, this multi-step bonding procedure is complex,
technique sensitive, and it involves significant chair
time. A new generation of self-adhesive resin
cements has been developed recently that eliminates
the need for etching, priming, and bonding as
separate steps. These self-adhesive resin cements
are based on new monomer, filler, and initiator
formulations. The acidic monomer replaces the
previous three steps by combining the use of
adhesive and cement into a single application. These
multi-functional phosphate-based acidic methacry-
lates can react with the basic fillers in the luting
cement and the hydroxyapatite of the hard tooth
tissue.2 Self-adhesive resin cements combine the
high-strength and low-solubility advantages of resin
cements with the characteristic ease of use of self-
adhesive systems, making them highly attractive to
the clinician.
Evidence is limited as to how the bond strength of
newer self-adhesive resin cements compares to that of
conventional self-adhesive resin-modified glass ion-
omer cements (RMGICs) when bonded to a variety of
prosthodontic materials under multiple testing con-
ditions. While RMGICs are self-adhesive and provide
simultaneous fluoride release, aspects such as water
absorption with the associated setting expansion,
potential for crack development, and less associated
esthetics make these cements less than ideal for
situations such as the cementation of all-ceramic
crowns.3 Recent studies have shown higher bond
strengths for self-adhesive resin cements compared to
RMGICs when bonded to a variety of materials such
as noble and non-noble alloys, zirconia, aluminum
oxide ceramic, and pressable ceramic.4,5
Different studies have reported on the bond
strength of self-adhesive resin cements to enamel
and dentin,1,2,6-9 as well as different substrates such
as alloys,10-13 ceramics,4,14 and polymers.15 However,
most of these studies concentrate on a single
substrate, type of setting reaction, or testing time.
As self-adhesive cements continue to gain popularity
for the cementation of indirect restorations, large
comparative studies are needed to gain a better
understanding of the overall behavior of these
cements under multiple testing conditions and when
bonded to a variety of prosthodontic substrates.
Therefore, the objective of this study was to
evaluate the shear bond strength (SBS) of three
dual polymerized self-adhesive resin cements and a
RMGIC to a variety of prosthodontic substrates (base
metal, noble metal, zirconia, ceramic, and resin
composite). Furthermore, this study aimed to eval-
uate differences in SBS values between 15 minutes
and 24 hours and between self-polymerizing (SP)
and light-polymerizing (LP) setting reactions for the
different cement-substrate combinations. The null
hypothesis was that there would be no significant
difference in mean SBS among the tested cements,
between SP and LP modes, and between 15 minutes
and 24 hours.
MATERIALS AND METHODS
Bonding Substrates
The bonding substrates, including commercial
names and composition are summarized in Table 1.
One hundred ninety-two specimens were prepared
for each of the following substrates: base metal,
noble alloy, densely sintered yttrium-stabilized zir-
conia, lithium disilicate glass ceramic, and resin
composite. For the metallic substrates, noble metal
rectangular pieces (15 mm long 3 5 mm wide 3 1 mm
high) and base metal cylindrical blocks (10 mm
diameter and 5 mm thick) were used. The original
188 Operative Dentistry

Table 1: Tested Materials, Type, Composition and Batch Numbers as Per Manufacturer’s Descriptions

Self-adhesive Cements

Group Type Composition Lot No. Manufacturer

RelyX Unicem Dual polymerized 55%-65% Glass powder 15%-25% 337810 3M ESPE (St Paul, MN,
self-adhesive resin Methacrylated phosphoric acid esters 10%- USA)
cement 20% TEGDMA 1%-5% Silane-treated silica
1%-5% Sodium persulfate

Multilink Automix Dual polymerized 22%-26% Dimethacrylates 6%-7% HEMA L27890 Ivoclar Vivadent (Schaan,
adhesive resin ,1% Benzoyl peroxide 40% Barium glass, Liechtenstein)
cement with self- YF3, spheroid mixed oxide
etching primer

Maxcem Elite Dual polymerized 19%-40% Methacrylate esther monomers 3100070 Kerr Corporation
self-adhesive resin Other—inert mineral fillers, activators (Orange, CA, USA)
cement stabilizers, colorants, YF3

FujiCEM Automix Resin-modified 30%-40% Polyacrylic acid 30%-40% Distilled 0404091 GC America (Alsip, IL,
glass ionomer water 2% Silica powder 20% Silicone dioxide USA)
cement 2%-3% Benzensulfonic acid sodium salt

Bonding Substrates

Base metal Identalloy Co 60% Cr 30% Other 10% Ivoclar Vivadent (Schaan,
Liechstenstein)

Noble metal Harmony Medium Au 77% Ag 13% Cu 8% Other 2% Ivoclar Vivadent (Schaan,
Liechstenstein)

Zirconia IPS e.max ZirCAD 87% ZrO2, Y2O3, HfO2, Al2O3 Ivoclar Vivadent (Schaan,
Liechstenstein)

Ceramic IPS e.max CAD . 57% SiO2, Li2O, K2O, P2O5, ZrO2, ZnO, Ivoclar Vivadent (Schaan,
Al2O3, MgO and pigments Liechstenstein)

Composite resin Z100 80%-90% Silane-treated ceramic 1–10% 3M ESPE (St Paul, MN,
BisGMA 1–10% TEGDMA ,1% 2- USA)
Benzotriazolyl-4-methylphenol

Abbreviations: Bis-GMA, bisphenol A glycidyl dimethacrylate; HEMA, 2-hydroxyethyl methacrylate; TEGDMA, triethylene glycol dimethacrylate; YF3, ytterbium
trifluoride.

zirconia and ceramic blocks were cut using a low-
speed saw (Isomet, Buehler, Lake Bluff, IL, USA) to
obtain square blocks (10 mm 3 10 mm 3 2 mm). The
zirconia specimens were sintered following manu-
facturer’s recommendations. The composite speci-
mens were fabricated using a ring-shaped mold (10
mm diameter and 2 mm height) and light polymer-
ized.
All substrates were embedded in a chemically
polymerized methacrylate (Fastray, HJ Bosworth,
Skokie, IL, USA). The exposed surfaces were
sequentially polished with 320-, 400-, and 600-grit
silicon carbide abrasive paper (SiC sandpaper,
Buehler) under water and air abraded with 50-lm
aluminum oxide particles at 1 bar and a distance of
10 mm for 10 seconds. The specimens were stored in
dry conditions at room temperature until ready to be
bonded.
Bonding and Testing
The cements tested are listed in Table 1. A sample
size of 12 specimens per study group (n=12) were
Sabatini & Others: Shear Bond Strength of Self-Adhesive Cements to Various Prosthodontic Substrates 189
prepared. All cement systems were mixed and
applied according to the manufacturer’s recommen-
dations for each substrate. For those cements
requiring the use of a primer, as for Multilink
Automix, the corresponding primer (Monobond Plus,
Ivoclar Vivadent, Amherst, NY, USA) was used
before application of the cement. All bonding
procedures were carried out in a temperature-,
humidity-, and light-controlled room with overhead
lighting that used orange filters to avoid polymeri-
zation of the materials due to ambient light photo-
activation. To avoid bias during the bonding proce-
dures, study groups were randomized.
The SBS for each cement-substrate combination
was tested at 15 minutes and 24 hours in both SP
and LP setting reactions. The specimens were
secured using a specially fabricated jig (Bonding
jig, Ultradent, South Jordan, UT, USA) with a
cylindrical mold of 2.38 mm in diameter. The
corresponding cement was injected into the cylindri-
cal mold, which was not filled to the top. For the LP
groups, specimens were polymerized following man-
ufacturer’s recommendations with a light curing
unit (Bluephase C8, Ivoclar Vivadent). A minimum
power density of 800 mW/cm2 was ensured by
periodically monitoring the unit’s output with a
radiometer (Demetron, Kerr, Orange, CA, USA). All
specimens were stored at 378C and 100% humidity
until ready to be tested.
Shear bond strength was measured using a
testing machine (Ultratester, Ultradent) at a test
speed of 1 mm/min. A notched crosshead designed to
match the diameter of the bonded specimen was
used to apply the testing load (Figure 1). Specimens
were stabilized in a testing jig, which was free to
move to facilitate positioning under the load. The
Figure 1. Shear bond strength universal testing machine with a
notched cross-head matching the diameter of the bonded specimen.
test base was then positioned so that the notched
crosshead was placed against the specimen surface,
and the notch was fitted on the diameter of the
bonded specimen. The load required to debond the
specimen was recorded and expressed in MPa by
dividing the load by the surface area of the bonded
specimen, and the mean SBS for each study group
was calculated.
Statistical Analyses
A Student t-test was used to determine whether
significant differences existed between setting reac-
tions (SP vs LP) and between testing times (15
minutes vs 24 hours) regardless of other variables. A
one-way analysis of variance (ANOVA) was per-
formed to evaluate whether significant differences
existed among cements stratified by setting reaction
and testing time irrespective of the substrate. A
multifactorial analysis with generalized linear model
was used to evaluate the effect of multiple covariates
(substrate, cement, and setting reaction) and all
their interactions on SBS at each testing time. Post
hoc analysis with Tukey test was conducted to
explore the presence of significant differences be-
tween specific substrate-cement combinations for
each testing condition (setting reaction and testing
time). For each substrate-cement combination, we
also reported pretesting failures or samples sponta-
neously debonded prior to testing. A significance
level of 0.05 was used for all tests. All statistical
analysis was performed with Statistical Package for
Social Sciences (SPSS) version 16.0 (SPSS Inc,
Chicago, IL, USA).
RESULTS
Effect of the Setting Reaction
Student t-test revealed significantly higher mean
SBS values for LP relative to SP groups at both
testing times irrespective of substrate-cement inter-
actions (p,0.001). At 15 minutes, mean SBS values
were 11.4 6 0.5 and 3.3 6 0.1 for LP and SP,
respectively. At 24 hours, mean SBS values were
15.8 6 0.8 and 11.6 6 0.4 MPa for LP and SP,
respectively. However, when specific interactions
were considered by a one-way ANOVA, a few
exceptions were observed. FujiCEM did not show
significant differences between SP and LP modes
when evaluated at either 15 minutes (p=0.40) or at
24 hours (p=0.54). All self-adhesive resin cements
showed significant differences between SP and LP
modes irrespective of the substrate at both testing
times. The only exception was RelyX Unicem, which
190 Operative Dentistry

Table 2: Mean Shear Bond Strength in MPa for the Different Cements by Setting Reaction and Testing Time*

Cements SP/15 min SP/24 h LP/15 min LP/24 h

Mean (SE) Mean (SE) Mean (SE) Mean (SE)

RelyX Unicem 1.5 (0.1)a 18.5 (0.8)a 11.4 (0.6)a 18.7 (1.3)a,b

Maxcem Elite 5.1 (0.2)b 11.7 (0.6)b 10.6 (0.4)a 16.8 (0.5)b

Multilink Automix 2.6 (0.3)c 8.9 (0.3)c 19.0 (1.1)b 21.8 (2.1)a

FujiCEM Automix 4.0 (0.1)d 5.3 (0.3)d 4.0 (0.2)c 5.6 (0.3)c

Abbreviations: LP, light-polymerizing mode; SE, standard error; SP, self-polymerizing mode.
* Different superscript letters represent significant differences between cements for each testing condition irrespective of substrate (Tukey test).

demonstrated no differences between SP and LP
modes when evaluated at 24 hours (p=0.89).
Effect of the Testing Time
Student t-test also demonstrated significantly higher
mean SBS values at 24 hours relative to 15 minutes
for both setting reactions irrespective of substrate-
cement combination (p,0.001). However, when
specific substrate-cement interactions were consid-
ered in a post hoc analysis, a few exceptions showed
no significant differences between testing times. In
LP mode, no significant differences were detected
between 15 minutes and 24 hours for Multilink
Automix bonded to base metal (p=0.87) and noble
metal (p=0.12), RelyX Unicem bonded to ceramic
(p=0.97), and FujiCEM bonded to base metal
(p=0.47) and zirconia (p=0.99). In SP mode, no
significant differences between 15 minutes and 24
hours were found for FujiCEM bonded to zirconia
(p=0.13) and ceramic (p=0.96).
Effect of the Cement
Table 2 summarizes mean SBS values for the
different cements under the different testing condi-
tions. One-way ANOVA revealed significant differ-
ences in mean SBS values among cements

Table 3: Generalized Linear Model for Multiple Comparisons of Substrates, Cements, and Setting Reactions, as Well as Their
Interactions (n=941)

Variable Type III Sum of Squares df Mean Square F Sig

Intercept 100378.499 1 100378.499 3523.329 0.000

Cement 10126.694 3 3375.565 118.484 0.000

Substrate 7018.774 4 1754.693 61.590 0.000

Setting reaction 9268.924 1 9268.924 325.343 0.000

Cement * substrate 7024.988 12 585.416 20.548 0.000

Cement * setting reaction 6245.785 3 2081.928 73.077 0.000

Substrate * setting reaction 3994.508 4 998.627 35.052 0.000

Cement * substrate * setting reaction 5197.472 12 433.123 15.203 0.000

2
Abbreviations: Adjusted R ,0.643; df, degree of freedom; F, F statistic; Sig, significance level.
Sabatini & Others: Shear Bond Strength of Self-Adhesive Cements to Various Prosthodontic Substrates 191

irrespective of substrate for each setting reaction
and testing time (p,0.001). Post hoc analysis with
Tukey test revealed that all cements were signifi-
cantly different from each other (p,0.001) except for
RelyX Unicem and Maxcem Elite in LP mode at 15
minutes (p=0.85). In LP mode at 24 hours, no
significant differences were shown between RelyX
Unicem and Multilink Automix (p=0.34) and RelyX
Unicem and Maxcem Elite (p=0.71). The highest
mean SBS was shown for RelyX Unicem and Multi-
link Automix in LP mode at 24 hours with values of
18.7 and 21.8 MPa, respectively.
Effect of Multiple Factors
Table 3 summarizes the results from the multifacto-
rial analysis. The generalized linear model revealed
that all factors (cement, substrate, and setting
reaction) as well as all of their interactions were
found to have a significant effect in the SBS
(p,0.001).
Mean SBS values for the different cement-sub-
strate combinations under different testing condi-
tions are summarized in Figure 2 and Table 4.
Significant differences were evidenced between
cements for each substrate under the same testing
conditions (letters in Table 4), and between sub-
strates for each cement under the same testing
conditions (letters in Figure 1). As shown in Figure
1, resin specimens bonded to RelyX Unicem and
Multilink Automix at 24 hours in LP mode showed
significantly higher SBS than the other substrates
(p,0.05). Resin specimens bonded to RelyX Unicem
also demonstrated significantly higher SBS than the
other substrates at 24 hours in SP mode (p,0.05).
Base metal bonded to Maxcem Elite showed signif-
icantly higher SBS than the other substrates at 24
hours (p,0.05). Post hoc analysis with Tukey test
shown in Table 4 revealed that FujiCEM Automix
consistently showed significantly lower mean SBS
than all other self-adhesive resin cements (p,0.05).
The only exception was when the different substrate-
cement combinations were evaluated in SP mode at
15 minutes.
Pretesting failures or specimens spontaneously
debonded prior to testing were observed in some
groups. As shown in Table 4, Rely X Unicem and
Multilink Automix showed debonding of only one
specimen from noble and base metal, respectively,

Figure 2. Mean shear bond strengths in MPa for the different study groups. For each time, polymerization method, and cement, same letter indicates
substrates that are not statistically different under the same testing conditions (setting reaction and testing time).
192 Operative Dentistry

Table 4: Mean Shear Bond Strengths in MPa for Each of the Tested Groups With Number of Pretest Failures or Samples
Spontaneously Debonded Prior to Testing*

Substrate Time Mode RelyX Unicem Maxcem Elite Multilink Automix FujiCEM Automix

Mean (SE) No. PTF Mean (SE) No. PTF Mean (SE) No. PTF Mean (SE) No. PTF

Base metal 15 min SP 1.0 (0.1)a 0 6.7 (0.2)b 0 2.6 (0.3)c 0 4.5 (0.2)d 0

LP 7.6 (0.2)a 0 11.5 (1.1)b 0 17.8 (0.8)c 0 5.2 (0.3)d 0

24 h SP 16.8 (0.7)a 0 18.5 (1.0)a 0 10.6 (0.6)b 0 6.6 (0.4)c 0

LP 14.3 (0.5)a 0 21.6 (1.1)b 0 18.0 (0.5)c 1 4.6 (0.8)d 0

Noble metal 15 min SP 1.6 (0.1)a 0 6.6 (0.4)b 0 4.0 (0.3)c 0 2.9 (0.2)d 0

LP 7.2 (0.2)a 1 9.2 (1.0)a 0 14.6 (0.7)b 0 1.8 (0.2)c 2

24 h SP 17.1 (1.6)a 0 10.4 (0.7)b 0 7.7 (0.5)b 0 3.8 (0.4)c 0

LP 13.4 (1.2)a 0 16.9 (0.8)b 0 15.9 (0.4)b 0 5.6 (0.6)c 2

Zirconia 15 min SP 1.4 (0.1)a 0 3.3 (0.3)a,b 0 3.0 (1.3)a,b 0 4.3 (0.3)b 1

LP 11.0 (0.6)a 0 10.9 (0.5)a 0 12.1 (1.3)a 0 4.4 (0.3)b 0

24 h SP 16.2 (1.2)a 0 11.9 (1.1)b 0 7.1 (0.3)c 0 5.1 (0.4)c 0

LP 16.6 (0.4)a 0 16.5 (0.7)a 0 8.7 (0.4)b 0 4.4 (0.5)c 0

Ceramic 15 min SP 1.7 (0.1)a 0 5.3 (0.4)b 0 2.4 (0.5)a 0 3.6 (0.1)c 0

LP 12.0 (0.4)a 0 10.8 (0.7)a 0 17.6 (0.8)b 0 2.9 (0.1)c 2

24 h SP 13.4 (0.7)a 0 7.7 (0.7)b 0 9.5 (0.5)b 0 3.6 (0.9)c 7

LP 12.0 (0.7)a 0 13.0 (0.9)a 0 12.5 (0.7)a 0 5.8 (0.4)b 0

Resin 15 min SP 1.7 (0.2)a 0 3.4 (0.3)b 2 1.1 (0.2)a 0 4.6 (0.1)c 0

LP 18.6 (1.0)a 0 10.7 (0.6)b 0 32.7 (2.6)c 0 6.0 (0.2)d 0

24 h SP 29.0 (1.2)a 0 10.0 (1.1)b 0 9.9 (0.7)b 0 6.5 (0.7)c 0

LP 37.4 (1.8)a 0 15.8 (1.3)b 0 53.6 (1.2)c 0 7.6 (0.7)d 0

Abbreviations: LP, light-polymerizing mode; PTF, Pretesting failures; SE, standard error; SP, self-polymerizing .
* Groups with the same superscript letter indicate cements that are not significantly different for each substrate under the same conditions (Tukey test).
Sabatini & Others: Shear Bond Strength of Self-Adhesive Cements to Various Prosthodontic Substrates 193
and Maxcem Elite showed debonding of two resin
specimens. FujiCEM showed a much higher rate of
pretesting failures predominantly to noble metal and
ceramic, with four and nine samples debonded,
respectively.
DISCUSSION
This study evaluated the shear bond strength of a
number of cements bonded to a variety of prostho-
dontic substrates tested at different times (15
minutes and 24 hours) and undergoing different
setting reactions (SP and LP). The null hypothesis
was rejected as significant differences in SBS were
detected among cements, between SP and LP modes,
and between 15 minutes and 24 hours. Furthermore,
results from the multiple comparisons revealed that
all interactions between the tested factors were also
found to be significant with certain combinations of
cement, substrate, and setting reaction showing
improved bond strengths.
Effect of the Setting Reaction
Overall, significantly higher SBS were demonstrat-
ed when specimens were light-activated compared
to values generated when the cements were allowed
to self-polymerize. Similar findings have been
reported in the literature.4,16-18 Light polymeriza-
tion yielded improved SBS of the three self-
adhesive resin cements, which was also shown to
be dependent on the cement. Different monomer
composition and polymerization conditions have
been shown to alter the degree of conversion,
resulting in variations in bond strength results.19
FujiCEM was the only cement that did not show
differences between setting reactions at either 15
minutes or 24 hours. A recent report demonstrated
that RMGIC acid-base and visible light polymeri-
zation reactions inhibit one another during the
early phases of setting,20 which may help explain
why no differences were observed between SP and
LP mode for FujiCEM. With the exception of
FujiCEM, all substrate-cement combinations dem-
onstrated higher SBS when light-activated. The
only exception was RelyX Unicem, which demon-
strated no differences between SP and LP modes
when evaluated at 24 hours. Both RMGIC and self-
adhesive resin cements set by an acid-base reaction
as well as a free radical polymerization reaction.
While dual polymerizing systems are known to
compensate for light attenuation through the
thickness of the indirect restoration,21 it has been
shown that, compared to RMGIC, resin cements
typically exhibit higher bond strengths when light-
activated.4 A number of studies have reported
higher degree of conversion under light-polymeri-
zation conditions for resin-based materials.17,18,22
Effect of the Testing Time
The SBS of all cements were also shown to be higher
after 24 hours relative to 15 minutes irrespective of
the substrate and type of setting reaction. This
might have been the result of the continued post-
irradiation polymerization reaction known to take
place after the reaction is initiated and that lasts for
up to 24 hours.23,24 With the exception of a few
groups, most substrate-cement combinations dem-
onstrated an increase in SBS after 24 hours when
evaluated in both setting reactions. In general,
these differences remained significant and were
more apparent for the three self-adhesive resin
cements than the RMGIC. Similar findings of
increased bond strength after 24 hours have been
reported previously for different cements.25 Fuji-
CEM showed only a slight increase in mean SBS
from 15 minutes to 24 hours. Some FujiCEM groups
showed no change (FujiCEM bonded to ceramic in
SP mode and FujiCEM bonded to zirconia in LP
mode) or even a decrease in SBS values (FujiCEM
bonded to base metal in LP mode) after 24 hours.
Although our study did not formally measure the
extent of the polymerization reaction, the slight-to-
no increase in SBS values for FujiCEM after 24
hours suggests an apparent contradiction with
previous studies, which have demonstrated that
the RMGIC acid-base reaction continues overtime if
undisturbed.26,27
Effect of the Cement and Multiple Interactions
Significantly higher SBS were evidenced for the
three self-adhesive resin cements compared to
FujiCEM for all testing conditions except in SP
mode at 15 minutes. This is in agreement with
previous studies, which have shown higher bond
strengths for resin-based cements relative to
RMGIC.4,28 The similar SBS values for all cements
when evaluated in SP mode at 15 minutes may have
been the result of a slow initial cross-linking of the
resin-based materials when they were allowed to
self-polymerize. Multilink Automix and RelyX Uni-
cem yielded the highest SBS irrespective of the
substrate. A recent study demonstrated similar
findings, with RelyX Unicem showing higher bond
strengths compared to FujiCEM when bonded to
base and noble metals, ceramic, and zirconia sub-
strates.5 Another study by Zhang and Degrange29
showed higher bond strengths for Multilink Automix
194
compared to other self-adhesive resin cements
regardless of the restorative substrate. The same
study also found that the bond strengths for many of
the tested cements were dependent on the nature of
the restorative substrate.29 This is coincident with
the results from our study which demonstrated that
the interactions between cement, substrate, and
setting reaction were also found to have a significant
effect in the bond strength. The synergistic behavior
whereby certain combinations of cement, substrate
and setting reaction are more favorable than others
indicates that the selection of the luting cement
should be partially dictated by the substrate and the
setting reaction. Resin bonded to Multilink Automix
and RelyX Unicem in LP mode, and resin bonded to
RelyX Unicem in SP mode showed higher SBS
values than any of the other combinations in all
testing conditions. Similar findings have been re-
ported for RelyX Unicem.4 Compatibility between
the resinous components in the matrix of cements
Multilink Automix and RelyX Unicem and those of
composite Z100 may have been partially responsible
for the observed results. Similarly, Maxcem Elite
showed higher SBS values to base metal relative to
all other substrates in all testing conditions. This
could have been the product of the surface oxides
known to make the base metal more reactive by
providing potential for chemical bonding.5 Presum-
ably, a greater chemical affinity between the
components of self-adhesive resin cements and those
of specific prosthodontic substrates may have been
responsible for the observed results. However, only
general estimations can be made based on the
information provided by the manufacturer because
specific details regarding the material’s chemical
composition are proprietary. As recommended in the
cements’ directions for use, air abrasion with 50-lm
aluminum oxide particles was used for surface
roughening of all the substrate materials prior to
bonding. Since the manufacturers do not specify
additional surface treatment before application of
the cement, no further surface treatments such as
acid-etching or silanization were used as this might
have led to different results. Only when bonding
with Multilink Automix, was Monobond Plus primer
used after air abrasion as per manufacturer’s
instructions.
As self-adhesive cements continue to gain accep-
tance in the market, large comparative studies are
needed to evaluate their behavior when bonded to a
variety of prosthodontic substrates and tested under
different testing conditions. Bond strength studies
represent valuable initial screening tests to assess
Operative Dentistry
the overall behavior and predict future clinical
performance of the materials and techniques under
investigation. However, care should be exercised
when extrapolating the results obtained from labo-
ratory studies to the expected clinical outcomes as in
vitro tests are subject to a number of limitations. In
the present study, a 24-hour immersion in a 378C
water bath was used prior to bond strength testing
since this represents the standard short-term stor-
age protocol recommended by the International
Organization for Standardization (ISO/TR 11405).30
Although the effects of thermal cycling and long-
term storage on the bond strength were not evalu-
ated as a part of this investigation, they are
important in the simulation of clinical conditions
and should be investigated in future laboratory
studies incorporating multiple variables such as
those included in the present study. Furthermore,
a direct comparison among studies seems unfair
since a number of aspects relative to the design and
methodology are known to vary between studies.
Since the aim of our study was to isolate specific
interactions between the tested cements and differ-
ent substrates, a simplified interfacial design was
used, whereby the luting cement was directly bonded
onto the substrate. A different methodology used in
some studies involves two substrates (adherends)
which are joined together by a luting cement
(adhesive).31 While this design resembles more
closely the clinical situation, whereby a prepared
tooth receives a laboratory-processed restoration, it
represents a more complex interface since three
different materials are joined together making it
difficult to isolate the specific interactions taking
place between the different components of the
interface and perhaps compromising the validity of
the results.
Further research is needed to validate the long-
term behavior of the different substrate-cement
combinations when tested in a variety of testing
conditions. No conclusions can be drawn based
solely on the results from bond strength studies.
Combining the results from bond strength studies
with those from microleakage and marginal adap-
tation studies may provide a more comprehensive
assessment of the performance of the systems under
investigation. Furthermore, inclusion of failure
mode analysis routinely in bond strength studies
may significantly contribute to a more accurate
interpretation of the obtained results, as well as
facilitate a better understanding of the mechanical
behavior and stress distribution of adhesive inter-
faces during failure.
Sabatini & Others: Shear Bond Strength of Self-Adhesive Cements to Various Prosthodontic Substrates 195
CONCLUSIONS
Within the limitations of the present in vitro study,
the following conclusions may be drawn:
1. The performance of the cements was greatly
dependent on the type of setting reaction, with
light-polymerized mode displaying significantly
higher bond strengths than self-polymerized
mode. The performance of the cements was also
dependent on testing time. After 24 hours, all
cements matured showing higher bond strengths
than initial values obtained at 15 minutes.
2. Overall, self-adhesive resin cements demonstrat-
ed higher bond strengths than RMGIC FujiCEM
Automix irrespective of the substrate for all
testing conditions. The best performance was
achieved for RelyX Unicem at 24 hours (SP and
LP modes) and Multilink Automix in LP mode (15
minutes and 24 hours).
3. The bond strength of the cements also varied
depending on the prosthodontic substrate, indi-
cating that selection of the cement should be
dictated partially by the substrate. Overall,
Multilink Automix and RelyX Unicem demon-
strated higher SBS when bonded to resin, and
Maxcem Elite demonstrated higher SBS when
bonded to base metal.
Conflict of Interest
The authors of this manuscript certify that they have no
proprietary, financial, or other personal interest of any nature
or kind in any product, service, and/or company that is
presented in this article.
(Accepted 1 May 2012)
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